Welcome to Dr. James Wilson's Adrenal Fatigue Blog

Maintaining Sanity in Times of Stress: How Stress Affects Mental Health

sad young man on benchIt’s not hard to see the physical effects of too much stress; things like muscle tension, fatigue, blood sugar imbalances and rising blood pressure (or dropping blood pressure with adrenal fatigue) are easy to recognize. However, sometimes stress takes an even greater toll on areas which aren’t as visible: your emotional health. Stress can contribute to depression, anxiety, irritability, cynicism, interpersonal problems, emotional exhaustion, and suicide. 1, 10 Chronically stressed people have a harder time responding to additional challenges and take a longer time to recover from them.2 Once you’re juggling the maximum number of balls you can handle, tossing in one more can bring the whole act tumbling to the ground and bring you to tears in the corner. This kind of stress puts a strain on your relationships and affects your ability to function at work. It’s hard to be productive when you can’t concentrate or remember details. A 2007 survey grouped stress, depression and anxiety together as the single largest cause of absences due to work-related illness.5

Stress can affect your mood in many ways. Stress hormones such as cortisol interact and interfere with various neurotransmitters such as serotonin and dopamine7 – brain chemicals involved in regulating mood. There is even evidence that exposure to excessive stress causes damage to brain structure in addition to function. 4

Image credit: Flickr user LeonskiA healthy stress response adapts to a challenge by mobilizing resources and energy, and then when the stress is over, shifting back into balance. Cortisol, secreted by the adrenal glands, is the primary stress hormone in humans and its main function is to help the body deal with all kinds of stress. Chronic pain, low blood sugar, or even giving a speech can induce a rise in your cortisol, which comes to the aid of your stressed body: reducing inflammation, raising blood sugar levels, assisting blood flow, and giving you the “edge” you need to meet the challenge. Once the stress is over, cortisol levels should drop and allow your body to rebalance. However, protracted stress can cause chronic cortisol elevation – and irritability, anxiety and depression. If the stress continues even longer, your adrenals can fatigue with the result that stress response system may not be able to continue to keep pace with the demand for cortisol. At this point, the stressors will still be there, but your ability to adapt to them and handle them will have diminished. Pain and inflammation can worsen, blood sugar levels may drop even lower – resulting in hypoglycemia and the related irritability, spaciness and fatigue. This makes it even more difficult to focus your thoughts or gather the “oomph” to take on any additional challenge, and depression can tighten its grip.

Dealing with stress, depression and its other emotional manifestations is difficult. However, it is possible to intervene in this downward spiral and improve your stress response and your mood.

Continue to part 2 – Stress Management Tips

About the Author

Dr. Lise NaugleDr. Lise Naugle is an associate of Dr. James L. Wilson. She assists healthcare professionals with clinical assessment and treatment protocols related to adrenal dysfunction and stress, and questions regarding the use of Doctor Wilson’s Original Formulations supplements. With eleven years in private practice and a focus on stress, adrenals, hormonal balance and mind-body connection, she offers both clinical astuteness and a wealth of practical knowledge. Dr. Naugle also maintains updated information about the latest scientific research on the hypothalamic-pituitary-adrenal axis function, endocrine balance and nutritional support for stress and develops educational materials about stress and health for clinicians and their patients.

References

1. Bhui KS, Dinos S, Stansfeld SA, White PD. A synthesis of the evidence for managing stress at work: a review of the reviews reporting on anxiety, depression, and absenteeism. J Environ Public Health. 2012;2012:515874. Epub 2012 Feb 14.
2. Brosschot JF, Benschop RJ, Godaert GL, Olff M, De Smet M, Heijnen CJ, Ballieux RE. Influence of life stress on immunological reactivity to mild psychological stress. Psychosom Med. 1994 May-Jun;56(3):216-24.
3. Chang EC, Hirsch JK, Sanna LJ, Jeglic EL, Fabian CG. A preliminary study of perfectionism and loneliness as predictors of depressive and anxious symptoms in Latinas: a top-down test of a model. J Couns Psychol. 2011 Jul;58(3):441-8.
4. Frodl T, O’Keane V. How does the brain deal with cumulative stress? A review with focus on developmental stress, HPA axis function and hippocampal structure in humans. Neurobiol Dis. 2012 Mar 9. [Epub ahead of print]
5. HSE. Health and Safety Statistics 2006/2007. http://www.hse.gov.uk/statistics/overall/hssh0607.pdf
6. Kieviet-Stijnen A, Visser A, Garssen B, Hudig W. Mindfulness-based stress reduction training for oncology patients: patients’ appraisal and changes in well-being. Patient Educ Couns. 2008 Sep;72(3):436-42. Epub 2008 Jul 25.
7. Krugers HJ, Karst H, Joels M. Interactions between noradrenaline and corticosteroids in the brain: from electrical activity to cognitive performance. Front Cell Neurosci. 2012;6:15. Epub 2012 Apr 9.
8. Martinsen, EW. The role of aerobic exercise in the treatment of depression. Stress Medicine 1987; 3(2): 93-100.
9. Mikolajczak M, Quoidbach J, Vanootighem V, Lambert F, Lahaye M, Fillée C, de Timary P. Cortisol awakening response (CAR)’s flexibility leads to larger and more consistent associations with psychological factors than CAR magnitude. Psychoneuroendocrinology. 2010 Jun;35(5):752-7. Epub 2009 Dec 2.
10. Spickard A Jr, Gabbe SG, Christensen JF. Mid-career burnout in generalist and specialist physicians. JAMA. 2002 Sep 25;288(12):1447-50.
11. VanderWeele TJ, Hawkley LC, Thisted RA, Cacioppo JT. A marginal structural model analysis for loneliness: implications for intervention trials and clinical practice. J Consult Clin Psychol. 2011 Apr;79(2):225-35.
12. Weir K.F.; Jose P.E. A comparison of the response styles theory and the hopelessness theory of depression in preadolescents. Journal of Early Adolescence, v28 n3 (2008 08 01): 356-374

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Let’s Talk About Sex … and Stress: Supporting Your Sexual Response

Sex as natural stress relief

tiger by Tambako the Jaguar

This post is rated R for Rawwr

Some studies show that short term stress or anxiety can actually increase sexual response and sex hormone production. In this type of stress, a branch of the nervous system called the sympathetic nervous system (SNS) is activated. The SNS stimulates release of adrenaline and noradrenaline from the adrenal glands, which creates a “fight or flight” response, preparing the body to stand up to or escape a stressor and making your heart beat faster and stronger—which also happens when you are aroused sexually. Moderate activation of the SNS—with intense exercise, for example—facilitates sexual arousal in women. In fact, sex hormones temporarily increase in response to brief stress in both men and women. So even though chronic stress interferes with sexual response and inhibits production of sex hormones, short duration stress can actually assist libido!  However, subjective reports of arousal don’t always correspond to physiological measures of arousal. In order to find enjoyment from sex, it is important that both your body and your brain are into it.

What’s really intriguing is that not only does stress impact your sex life (see part 1 on the effects of stress on sex drive), but the reverse is true: your sex life can impact your ability to handle stress! Women who had positive physical contact from their partners prior to a stressful event exhibited significantly lower cortisol levels and heart rate responses to the stress. Interestingly, verbal support from partners did nothing to reduce the women’s stress response. In another study, intimacy in couples’ everyday life was associated with reduced daily cortisol levels. Intimacy seemed to offer a buffering effect against work-related elevations in cortisol.

Ways to enhance both your sexual response and your stress response:

  • massage by zaphodsotherheadGive and receive positive physical contact. Hold hands, dance, give your partner a back rub, hug each other. This helps combat the stress response, and it can foster a positive emotional connection. Both emotional and physiological arousal are important in a healthy sexual response.
  • Find ways to leave your stress outside the bedroom door. Write down the things that you need to remember so they will be less apt to intrude in your brain at inopportune times. Distraction can be a real mood-killer.
  • Try snuggling up with your love for a scary movie or paddling some class IV white water rapids together. Short term stress can increase sexual response.
  • Support your stress response system nutritionally. Herbs like ashwagandha and eleutherococcus (formerly Siberian ginseng) help your body adapt to stress, while maca has been shown to support healthy sexual function in both men and women.
  • If you have adrenal fatigue, support your adrenals with nutritional supplements – such as B vitamins, vitamin C, manganese, magnesium and adaptogenic herbs. This can help them produce the DHEA you need for libido as well as the cortisol you need to manage stress.
  • Hit the gym for a quick work out. A brief bout of intense exercise facilitates physiological arousal.
  • Keep it fun. Focus on the process rather than the end. Don’t add stress needlessly.
  • Make time to practice physical intimacy with your partner. This in itself can reduce cortisol levels, and reduced cortisol levels are associated with improved sexual response.

Don’t let stress take over the bedroom. Practice connection, inject a little excitement, and keep things fun. As you manage your stress response, you’ll be supporting your sexual response, and by supporting your sexuality, you’ll receive the added benefit of reducing your stress in the process.

Photo credits: Flickr users Tamboko the Jaguar and zaphodsotherhead

About the Author

Dr. Lise NaugleDr. Lise Naugle is an associate of Dr. James L. Wilson. She assists healthcare professionals with clinical assessment and treatment protocols related to adrenal dysfunction and stress, and questions regarding the use of Doctor Wilson’s Original Formulations supplements. With eleven years in private practice and a focus on stress, adrenals, hormonal balance and mind-body connection, she offers both clinical astuteness and a wealth of practical knowledge. Dr. Naugle also maintains updated information about the latest scientific research on the hypothalamic-pituitary-adrenal axis function, endocrine balance and nutritional support for stress and develops educational materials about stress and health for clinicians and their patients.

References

Bradford A, Meston CM. The impact of anxiety on sexual arousal in women. Behav Res Ther. 2006 Aug;44(8):1067-77. Epub 2005 Sep 30.
Brooks NA, Wilcox G, Walker KZ et al. Beneficial effects of Lepidium meyenii (Maca) on psychological symptoms and measures of sexual dysfunction in postmenopausal woman are not related to estrogen or androgen content. Menopause. 2008 Nov-Dec;15(6):1157-1162.
Ditzen B, Hoppmann C, Klumb P. Positive couple interactions and daily cortisol: on the stress-protecting role of intimacy. Psychosom Med. 2008 Oct;70(8):883-9. Epub 2008 Oct 8.
Ditzen B, Neumann ID, Bodenmann G, von Dawans B, Turner RA, Ehlert U, Heinrichs M. Effects of different kinds of couple interaction on cortisol and heart rate responses to stress in women. Psychoneuroendocrinology. 2007 Jun;32(5):565-74. Epub 2007 May 11.
Hamilton LD, Meston CM. The role of salivary cortisol and DHEA-S in response to sexual, humorous, and anxiety-inducing stimuli. Horm Behav. 2011 May;59(5):765-71. Epub 2010 Dec 30.
Hamilton LD, Rellini AH, Meston CM. Cortisol, sexual arousal, and affect in response to sexual stimuli. J Sex Med. 2008 Sep;5(9):2111-8. Epub 2008 Jul 4.
Lennartsson AK, Kushnir MM, Bergquist J, Billig H, Jonsdottir IH. Sex steroid levels temporarily increase in response to acute psychosocial stress in healthy men and women. Int J Psychophysiol. 2012 Mar 9. [Epub ahead of print]
Rivier C, Rivest S. Effect of stress on the activity of the hypothalamic-pituitary-gonadal axis: peripheral and central mechanisms. Biol Reprod. 1991 Oct;45(4):523-32.
Shin BC, Lee MS, Yang EJ, Lim HS, Ernst E.Maca (L. meyenii) for improving sexual function: a systematic review. BMC Complement Altern Med. 2010 Aug 6;10:44. Review.
Ter Kuile MM, Vigeveno D, Laan E. Preliminary evidence that acute and chronic daily psychological stress affect sexual arousal in sexually functional women. Behav Res Ther. 2007 Sep;45(9):2078-89. Epub 2007 Mar 19.
Zenico T, Cicero AF, Valmorri L, Mercuriali M, Bercovich E. Subjective effects of Lepidium meyenii (Maca) extract on well-being and sexual performance in patients with mild erectile dysfunction: a randomized, double-blind clinical trial. Andrologia. 2001 Apr; 41(2):95-9.

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Let’s talk about sex … and stress: The effects of stress on sex drive

It’s a Friday evening, and you’re looking forward to a special evening alone with your partner. You collect your things to leave the office … when your boss dumps an extra project on your desk for the weekend. Then some hotshot in a turbocharged sports car cuts you off, and you spill your drink on your lap. By the time you finally arrive at home, you realize you left your passion somewhere between your desk and the exit ramp.

The Relationship Between Stress and Sex

man not interested in sexThe relationship between stress and sex is complex, but clinicians and lovers have long recognized stress’s ability to interfere with human sexuality and reproduction. The stress response is controlled by the hypothalamic-pituitary-adrenal (HPA) axis. The sexual response is controlled by the hypothalamic-pituitary-gonadal (HPG) axis. Notice some similarities? The hypothalamus is a part of the brain that controls the “four Fs” of our most basic instincts: fighting, fleeing, feeding, and … mating. The hypothalamus directs the pituitary, or “master gland,” which is found as a small protrusion off of the hypothalamus. The pituitary controls the secretion of hormones throughout the body. Depending on the messages it receives from the hypothalamus, it may signal the adrenals to secrete cortisol, a stress hormone, or the gonads to secrete sex hormones. Stress hormones can impact and interfere with sexual function at all three levels of the HPG axis: at the brain, pituitary, and gonads.

However, in addition to stress hormones, the adrenals can also produce DHEA, a sex hormone. DHEA is a precursor to both testosterone and estrogen. Although testosterone is often thought of as a male hormone, women also have it in smaller amounts, and it has a strong impact on libido. In menstruating women, the ovaries are the major source of testosterone, but the adrenals contribute via their production of DHEA. After menopause, the adrenals become critical to a woman’s supply. If a woman has adrenal fatigue, not only will her production of stress hormones decrease, but her testosterone—and her libido—will too.

Higher stress is associated with reduced sexual functioning in general. Women who had higher levels of cortisol (the stress hormone) and lower levels of DHEA (the sex hormone) after watching an erotic movie experienced less physiological arousal than women with a lower cortisol/DHEA ratio. Prolonged stress has been shown to decrease sexual response in women, and women with greater levels of chronic daily stress report more sexual complaints.

Stress can interfere with sex on a psychological level, too. Cognitive distraction (thinking or worrying about problems) interferes with sexual functioning. So if you are ruminating about multiple stressors, it will be difficult to put your full attention on either your partner or your own sensations and responses.

Continue to part 2 – Supporting Your Sexual Response

Photo credit: Flickr user focus.recompose

References

Bradford A, Meston CM. The impact of anxiety on sexual arousal in women. Behav Res Ther. 2006 Aug;44(8):1067-77. Epub 2005 Sep 30.
Brooks NA, Wilcox G, Walker KZ et al. Beneficial effects of Lepidium meyenii (Maca) on psychological symptoms and measures of sexual dysfunction in postmenopausal woman are not related to estrogen or androgen content. Menopause. 2008 Nov-Dec;15(6):1157-1162.
Ditzen B, Hoppmann C, Klumb P. Positive couple interactions and daily cortisol: on the stress-protecting role of intimacy. Psychosom Med. 2008 Oct;70(8):883-9. Epub 2008 Oct 8.
Ditzen B, Neumann ID, Bodenmann G, von Dawans B, Turner RA, Ehlert U, Heinrichs M. Effects of different kinds of couple interaction on cortisol and heart rate responses to stress in women. Psychoneuroendocrinology. 2007 Jun;32(5):565-74. Epub 2007 May 11.
Hamilton LD, Meston CM. The role of salivary cortisol and DHEA-S in response to sexual, humorous, and anxiety-inducing stimuli. Horm Behav. 2011 May;59(5):765-71. Epub 2010 Dec 30.
Hamilton LD, Rellini AH, Meston CM. Cortisol, sexual arousal, and affect in response to sexual stimuli. J Sex Med. 2008 Sep;5(9):2111-8. Epub 2008 Jul 4.
Lennartsson AK, Kushnir MM, Bergquist J, Billig H, Jonsdottir IH. Sex steroid levels temporarily increase in response to acute psychosocial stress in healthy men and women. Int J Psychophysiol. 2012 Mar 9. [Epub ahead of print]
Rivier C, Rivest S. Effect of stress on the activity of the hypothalamic-pituitary-gonadal axis: peripheral and central mechanisms. Biol Reprod. 1991 Oct;45(4):523-32.
Shin BC, Lee MS, Yang EJ, Lim HS, Ernst E.Maca (L. meyenii) for improving sexual function: a systematic review. BMC Complement Altern Med. 2010 Aug 6;10:44. Review.
Ter Kuile MM, Vigeveno D, Laan E. Preliminary evidence that acute and chronic daily psychological stress affect sexual arousal in sexually functional women. Behav Res Ther. 2007 Sep;45(9):2078-89. Epub 2007 Mar 19.
Zenico T, Cicero AF, Valmorri L, Mercuriali M, Bercovich E. Subjective effects of Lepidium meyenii (Maca) extract on well-being and sexual performance in patients with mild erectile dysfunction: a randomized, double-blind clinical trial. Andrologia. 2001 Apr; 41(2):95-9.

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How to Save Your Sleep and Manage Stress

comfortable bed

How to save your sleep and manage your stress

Now that we’ve discussed the sleep-stress connection, let’s talk about how to save that precious sleep and better manage stress. Higher subjective ratings of stress during the day are associated with poorer sleep. Conversely, poorer sleep is associated with higher ratings of stress during the day. Therefore, anywhere you are able to impact this vicious cycle is likely to help both.

  • Try to maintain a regular bedtime and waking time to reinforce the daily cycle.

  • Light is a factor in maintaining the daily rhythm. Avoid staring at a bright television or computer screen an hour before bedtime, and keep your bedroom as dark as possible while you sleep.
  • Have a small snack including complex carbohydrate (whole grains, root vegetables, etc.) and protein (nuts, chicken, fish, eggs, etc.) before bed to avoid low blood sugar during the night and a resultant rise in cortisol.
  • Minimize nighttime interruptions. Turn off your phone, and if noise is a factor where you sleep, try using white noise to relax and dampen sounds.
  • Vigorous exercise can help dissipate stress. However, a high intensity work out late in the evening may interfere with sleep. Gentle exercise just before bed, especially for those with adrenal fatigue, may promote sleep.
  • Support the adrenals and HPA axis with nutrients and adaptogens, herbs that help the system respond to stress, such as eleutherococcus (formerly Siberian ginseng), ashwagandha, maca and licorice.
  • Socialize with friends. It relieves stress and supports the adrenals.
  • Practice some form of relaxation and stretching such as yoga. In a trial looking at the effects of either an 8 week yoga or an 8 week educational film program on stress, mood and blood pressure in postmenopausal women, the yoga group showed significant improvements in sleep quality, mood, perceived stress and blood pressure compared to the film group.

Don’t lose sleep over stress. Support your sleep pattern and your stress response to get a better night’s sleep and avoid some of the problems associated with stress and long term sleep disorders.

References

Aldabal, L. and A. S. Bahammam (2011). “Metabolic, endocrine, and immune consequences of sleep deprivation.” Open Respir Med J 5: 31-43.

Backhaus, J., K. Junghanns, et al. (2004). “Sleep disturbances are correlated with decreased morning awakening salivary cortisol.” Psychoneuroendocrinology 29(9): 1184-1191.

Balbo, M., R. Leproult, et al. (2010). “Impact of sleep and its disturbances on hypothalamo-pituitary-adrenal axis activity.” Int J Endocrinol 2010: 759234.

Benedict, C., W. Kern, et al. (2009). “Early morning rise in hypothalamic-pituitary-adrenal activity: a role for maintaining the brain’s energy balance.” Psychoneuroendocrinology 34(3): 455-462.

Eek, F., B. Karlson, et al. (2012). “Cortisol, sleep, and recovery – Some gender differences but no straight associations.” Psychoneuroendocrinology 37(1): 56-64.

Garde, A. H., K. Albertsen, et al. (2011). “Bi-directional associations between psychological arousal, cortisol, and sleep.” Behav Sleep Med 10(1): 28-40.

Innes, K. E. and T. K. Selfe (2012). “The Effects of a Gentle Yoga Program on Sleep, Mood, and Blood Pressure in Older Women with Restless Legs Syndrome (RLS): A Preliminary Randomized Controlled Trial.” Evid Based Complement Alternat Med 2012: 294058.

Lattova, Z., M. Keckeis, et al. (2011). “The stress hormone system in various sleep disorders.” J Psychiatr Res 45(9): 1223-1228.

Spath-Schwalbe, E., T. Scholler, et al. (1992). “Nocturnal adrenocorticotropin and cortisol secretion depends on sleep duration and decreases in association with spontaneous awakening in the morning.” J Clin Endocrinol Metab 75(6): 1431-1435.

Woods, N. F., E. S. Mitchell, et al. (2009). “Cortisol levels during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women’s Health Study.” Menopause 16(4): 708-718.

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Got Stress? How’s Your Sleep?

The sleep-stress connection

fragmented stressed woman by ZolfoWho hasn’t experienced a restless night full of tossing and turning from worry about a test, interview or presentation the next day? Stress and worry affect your quality of sleep which, in turn, affects your ability to handle stress. Difficulties with sleep or stress management can produce a vicious circle of decreased sleep and increased stress.

Although the sleep-stress link is complex, and researchers are unclear on the exact physiology behind it, we do have some clues. The hypothalamic-pituitary-adrenal (HPA) axis is the primary regulator of the stress response. The hypothalamus, a part of the brain, directs the pituitary, another gland in the brain, to signal the adrenal glands, located above the kidneys. In response to this signal the adrenal glands secrete stress hormones, like adrenaline and cortisol, that have widespread effects throughout the body: raising blood pressure, elevating blood sugar, increasing heart rate, and even causing anxiety.

The level of cortisol the body produces has a normal daily rhythm that somewhat parallels the normal sleep-wake cycle. Cortisol peaks in the early morning, declines throughout the day, and reaches a low around midnight. The level starts to rise again during the second half of the night. However, many types of stress (extreme physical activity, worry about a family member’s health, going too long between meals) can trigger the stress response and disrupt this normal cycle.

Excessive stress can cause healthy adrenal glands to increase cortisol output throughout the day and into the evening, putting a burden on the body from all the metabolic changes induced by the hormone. On the other hand, in people with adrenal fatigue, cortisol levels typically can’t reach their normal morning high or rise in response to demand, making it more difficult to handle any stress.

Effects of lack of sleep

alarm clock and sleeping womanProlonged insomnia is associated with elevated nighttime cortisol levels and lower morning cortisol levels. People who chronically sleep less than 9 hours a night tend to have higher cortisol levels throughout the time that they sleep and are at higher risk for obesity and diabetes than people who sleep for more than 9 hours.

The evidence for the relationship between short-term lack of sleep and cortisol is a bit more contradictory. After a period of sleep loss, some studies show elevation of cortisol, while others report a decrease in cortisol. Some researchers theorize that, initially, the stress response system is stimulated in order to cope with and adapt to sleep loss, but over time the continued lack of sleep causes a blunting of the response. This could also be due to an inability of the adrenal glands to continue to respond to the stressor.

One of the primary functions of sleep is to consolidate new memories. Much of this process involving memories about facts and information happens during slow wave sleep, which occurs in the early night. When low dose cortisol was given to people during this sleep phase (similar to what could occur in the body under stress), their memory was impaired.

Although we’re not clear on which may be the proverbial chicken or egg, sleep disturbances and cortisol imbalances are both common in insomnia, depression, sleep apnea, restless leg syndrome, menopause, Cushing’s syndrome (a syndrome in which cortisol is significantly high) and adrenal fatigue (in which cortisol is significantly low).

Continue to part 2: How to Save Your Sleep and Manage Your Stress

About the author

Dr. Lise NaugleDr. Lise Naugle is an associate of Dr. James L. Wilson. She assists healthcare professionals with clinical assessment and treatment protocols related to adrenal dysfunction and stress, and questions regarding the use of Doctor Wilson’s Original Formulations supplements. With eleven years in private practice and a focus on stress, adrenals, hormonal balance and mind-body connection, she offers both clinical astuteness and a wealth of practical knowledge. Dr. Naugle also maintains updated information about the latest scientific research on the hypothalamic-pituitary-adrenal axis function, endocrine balance and nutritional support for stress and develops educational materials about stress and health for clinicians and their patients.

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Saving Sleep, Sex and Sanity in a Stressful World: Introduction

Got stress? That’s a pretty easy question to answer, and one to which most of us would reply to with an emphatic “Yes!” Here’s another question: How’s your sleep, sex and sanity? Most of us can name at least one of those areas as something we’d do anything to save, as well as hundreds of reasons how it got so bad in the first place, like:

I’m just too tired.
I’m too busy to think about it right now.
I’ll catch up on sleep over the weekend.
I’ll feel better when …

Stress can be bad news for sleep, sex and sanity. For the rest of April, which is National Stress Awareness month, we’re focusing on each of these topics and just how stress affects each one. Better yet, we’ll share what you can do to save your sleep, sex and sanity in a stressful world. Here’s an overview to get started:

businesswoman asleep on the couchSleep

Stress and worry affect your quality of sleep, and your quality of sleep, in turn, affects your ability to manage stress. Difficulties with either sleeping or managing stress can result in difficulties in the other, causing a vicious circle of decreased sleep and increased stress.

 

rose petals on a pillowSex

A healthy sex life is affected by libido, performance, energy and opportunity – all of which can be undermined by stress. Stress related psycho-emotional factors that put additional strains on relationships and self-image, as well as adrenal fatigue and metabolic syndrome, can also put a damper on sexual health and performance.

 

man going insaneSanity

Feeling stressed is synonymous with feeling unhappy, pressured, dissatisfied, chaotic and a little crazy. Depression, PTSD and neurotic behavior are just some of the mental health issues caused or exacerbated by high or chronic stress.

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Signs and Symptoms of Stress

stressed woman holding her faceIn order to get a true grasp on stress, you first must learn how to recognize it in yourself. The mind, body and judgment are affected by stress in many ways, and they’re all directly tied to the physiological changes of the fight-or-flight response. There are no set signs and symptoms of stress, as these vary widely from person to person. Some experience primarily physical symptoms, like lower back pain, stomach problems and outbreaks on the skin. In others, the stress pattern centers around emotional symptoms, such as crying spells or hypersensitivity. For others, the changes mostly affect their behavior or thought processes. Below are some of the more common signs and symptoms of stress, broken down by category. (It’s important to note that the signs and symptoms of stress can also be caused by other psychological and medical problems.)

Cognitive Symptoms       

  • Forgetfulness
  • Poor short-term memory
  • Difficulty focusing
  • Indecisiveness
  • Difficulty concentrating
  • Trouble thinking clearly
  • Poor behavior/being unlike one’s self
  • Focusing on the negative
  • Racing or anxious thoughts

Emotional Symptoms

• Constant worrying
• Fearful anticipation
• Agitation and moodiness
• Restlessness
• Short temper
• Irritability, impatience
• Inability to relax
• Feeling tense and “on edge”
• Feeling overwhelmed
• Sense of loneliness and isolation

Behavioral Symptoms

• Decrease in sex drive/libido
• Eating less or more then usual
• Habitual craving for salty or sweet foods
• Sleeping too much or too little
• Neglecting responsibilities
• Avoiding contact with others
• Using alcohol, tobacco, or drugs to unwind
• Nervous habits (e.g. pacing or nail biting)
• “Overdoing it” (e.g. exercising, working)
•  Using caffeine to stay going
• Becoming argumentative or combative
• Overreacting to unexpected problems

Physical / Physiological Symptoms

• Chronic fatigue
• Tense pain in head and/or back
• Stiffness and tension in muscles
• Constipation or diarrhea
• Nausea, dizziness
• Difficulty sleeping/insomnia
• Increased heart rate/chest pain
• Increase or decrease in blood pressure
• Loss or gain in weight
• High or low blood sugar
• Skin conditions (e.g. eczema, hives)
• Frequent or prolonged colds

If you’re experiencing any of the warning signs of stress, it’s important to see your health-care professional for a full evaluation. A healthcare practitioner who is familiar with how stress and adrenal fatigue affects overall health can help you determine whether or not your symptoms are related to stress. Dr. Wilson’s Adrenal Fatigue Program may help your adrenal glands and the stress response system better cope with stress. Providing you make appropriate diet and lifestyle changes, you can help put an end to the suffering caused by 21st century stress.

About the Author

Dr Eric BakkerEric Bakker B.H.Sc. (Comp.Med), N.D, R.Hom. is a highly experienced naturopathic physician who has been in clinical practice for 25 years. Eric is passionate about improving people’s lives through proven wellness and lifestyle principles, natural medicine practice as well as public and professional practitioner education. Eric specialises in candida yeast infections, as well as adrenal fatigue, and thyroid disorders. Dr. Bakker has written one of the most comprehensive books on yeast infections called Candida Crusher. Website:  candidacrusher.com  You can complete his online survey to determine if you have a yeast infection here, or link through to his many You Tube videos: www.yeastinfection.org  Dr. Bakker’s Blog:  www.ericbakker.com

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Recipe: Dairy and Gluten Free Lasagna

lasagna by Flickr user VancityAllieThose with food allergies usually have to skip the lasagna. With this dairy and gluten free lasagna, feel free to take a second look. For Vegetarian Lasagna: Follow the recipe below but substitute firm, drained and crumbled tofu or chopped tempeh for the ground meat.

Ingredients:

  • 2 boxes rice lasagna noodles
  • 4-5 cups tomato sauce – 2 jars (read label to make sure it doesn’t contain cheese or wheat/gluten)
  • 2 pounds ground beef (or ground turkey or chicken)
  • 3 Tbsp. olive oil
  • 1 red or sweet onion – peeled and chopped
  • 4 cloves garlic – peeled and crushed
  • salt, pepper, basil, oregano, ground fennel – to taste
  • 6-8 cups fresh spinach
  • 2 cups mushrooms – sliced
  • 2 sweet potatoes – cooked and peeled
  • 1 medium butternut squash – cooked, seeds removed and peeled
  • salt, pepper, basil, oregano, ground fennel – to taste
  • option 1 –  2-3 cups grated vegan cheese (read label to make sure it doesn’t contain milk or casein)
  • option 2 – 2 roasted red peppers (seeds removed) – 1 jar

Directions:

1) Heat 1 Tbsp. oil in frying pan over medium heat. Add onion and saute until just beginning to brown. Add garlic and ground meat and cook stirring occasionally until cooked through. Season with salt, pepper, basil, oregano and ground fennel – to taste. Remove from heat.

2) Heat 1 Tbsp. oil in frying pan over medium heat. Add sliced mushrooms and sauté for 2-3 minutes. Remove from heat.

3) Wash spinach. Put in pot and cover with a lid. Heat over medium, stirring once or twice, just until spinach starts to wilt (2-3 minutes). Remove from heat and roll spinach in several layers of paper towel to drain.

4) Boiling rice lasagna noodles in water first is optional but makes the finished lasagna moister and easier to cut.  To boil noodles, bring several quarts of salted water to a rolling boil in a large pot. Add 1 tablespoon of oil and the 2 packages of noodles to pot. Boil uncovered for 8 minutes. Drain. If you don’t boil the noodles, just proceed with the uncooked noodles.

5) Mash squash and sweet potato together until smooth.

6) Assembly: Cover bottom of lasagna pan (at least 9”x13”x3”) with 1 cup tomato sauce. Lay a single layer of noodles over the sauce, overlapping edges. Cover with ½ cooked meat, then a layer of ½ spinach, then a layer of ½ mashed squash mixture and a layer of ½ mushrooms and another cup of tomato sauce. Repeat this layering process starting with a layer of noodles. Cover top with noodles and remaining tomato sauce. If using dairy-free cheese, sprinkle top with cheese. If using roasted pepper, lay slices of the pepper over top of lasagna.

7) Cooking: Cover tightly with lightly oiled tin foil. Put lasagna dish on a cookie sheet to catch and spills. Place in preheated oven (350 F) and bake for 40-50 minutes until liquid is bubbling. Remove foil and let sit to cool for 5 minutes before cutting. Serve with salad.

 

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Eliminating Food Allergies, Sensitivities, and Intolerances

In part 1 and part 2 of this blog, I explained various ways you may be sensitive, allergic or intolerant to certain foods, how these can impact your health and put additional stress on your adrenals, and some ways to begin to identify problematic foods.  In Part 3 below, I’ll show you how to clarify your suspicions that some foods may be bothering you and eliminate these problem foods from your diet.

The value of an elimination and challenge diet

banned

Image credit: Flickr user uvw916a

If you are eating nutritious foods, getting sufficient rest, exercising, and creating quality time alone or with people you care about yet don’t feel as well as you think you should, hidden food allergies, sensitivities and intolerances could be at fault. They can impact your immune system, your digestive system, and your ability to tolerate stress.  They are associated with and can cause or complicate chronic health problems – particularly the following:

  • auto-immune conditions
  • digestive issues
  • joint or muscle pain
  • neurological or emotional issues (like migraines, ADHD, depression, and some coordination problems)
  • eczema or allergies

There are many variations on the elimination and challenge diet, but all share common characteristics. In a nutshell, the elimination portion of the diet removes potentially offending foods from your diet; the challenge portion puts the foods back into your diet one at a time and allows you to discover which ones are causing problems. Unlike an immediate allergic reaction such as hives, swelling or shortness of breath, many food sensitivities or intolerances create more subtle or chronic problems in your body – such as joint pain, fatigue, digestive disturbances, or emotional or behavioral issues. If you eat the problematic food regularly, the related reactions can be so chronic that there is no clear cause and effect between the offending food and your symptoms. By removing the food for a short period of time, you can allow your reaction to lessen. Then after a period of time, you reintroduce the food. If you then experience the same symptoms that you had been experiencing chronically, a link between the food and the symptom becomes more easily identifiable.

How to begin

Before you begin the elimination, list any symptoms that are currently problematic for you across the top of a page. Below them list today’s date, then give each symptom a numerical value from 1-5 based on average severity over the past 2 weeks (1 = extremely mild, 5 = extremely severe). These symptoms may be anything from abdominal cramping to mood swings. If you have a symptom that isn’t always present but rather comes and goes, such as a migraine or heart palpitations, record how frequently you experience it (e.g. once a month, twice a week, etc.) It can also be helpful to record your weight and body measurements at this time since food sensitivities can sometimes contribute to water retention.

Eliminating foods

NOTE: Do NOT do an elimination and challenge diet without consulting your doctor if you have ever experienced an anaphylactic reaction to a food or are already aware of food allergies which cause airway restriction.

If you believe that your food reactions are linked to only a few foods, you could choose to simply eliminate those to begin with. However, it is usually best (although more difficult) to remove as many potentially problematic foods as possible, not only to increase your odds of discovering the ones that are causing difficulties, but because sometimes it is the combination of foods, rather than a single food, that is at issue. Also, it is sometimes the foods you crave and eat regularly that are the main culprits. The primary categories of food to include in the elimination and challenge are below

Categories to Eliminate

Examples of Category (not comprehensive)

Wheat and Gluten-containing grains white or wheat bread, pasta, bulgur, rye crackers, barley, spelt, barley, soy sauce
Dairy and dairy products milk, ice cream, cream-based soups, yogurt, cheese, casein, butter, cookies
Corn and corn products popcorn, corn syrup, corn batters, dextrin, ketchup, tortillas
Citrus fruits oranges, orange juice, lemons, citrus beverages
Eggs mayonnaise, noodles, cakes, bread, albumin
Shellfish shrimp, crab, mussels, scallops, clams
Processed meats hotdogs, sausage, lunch meats
Soy soy sauce, tofu, tempeh, edamame, soy ice cream
Peanuts Peanut butter
Artificial preservatives, colorings, sweeteners BHA, BHT, yellow dye # 5, aspartame, saccharine, MSG
Sugar, caffeine, alcohol, hydrogenated oils Dextrose, high fructose corn syrup, coffee, chocolate, colas, beer, wine, partially hydrogenated oils

If a food is not on this list but you eat it almost every day, it may be helpful to test that food, and obviously, if you suspect a food other than those included on the list above, add it to your list. For example, some people with joint pain are especially sensitive to substances called alkaloids found in a group of plants commonly known as nightshades. If joint pain is an issue of yours, it may be helpful to eliminate and challenge nightshade vegetables as well. These include potatoes, tomatoes, eggplant, and peppers.

Supporting yourself through the process

make it happenThe goal is to eliminate each of the foods on your list for a period of 1-3 weeks. Although the concept of an elimination diet is relatively simple, it is anything but easy. If you suddenly feel panicked at the thought of giving up your morning latte and scone, allow that feeling and observe it. Sometimes psychological “addictions” to foods are clues to sensitivities. Give yourself time to prepare for the elimination emotionally. It can be hard to completely alter your eating patterns, and it often involves altering your lifestyle as well. I encourage you to nurture yourself during the elimination and to use the time to take care of yourself emotionally, socially and physically, eliminating those things, people or behaviors from your life which are not healthy, and bringing in those that are. This is a good time to incorporate a yoga, meditation or gentle exercise program. It is not a good time to begin a very strenuous exercise program if you are not already used to it! As you eliminate foods, your body may experience some physical withdrawals or detoxification reactions. In fact, sometimes headaches, body aches, fatigue and irritability may actually increase the first few days. During this time, drink plenty of water and eat a variety of colorful vegetables and fruits. These foods are high in antioxidants and provide important nutrients required by the liver to carry out detoxification. Extra vitamin C (non-corn sourced) can be helpful as well. Be gentle with yourself and realize that this is not an exercise in deprivation; you have chosen to eliminate and challenge these foods to discover more about your body and experience more energy and vitality! Also remember that the elimination phase does not last forever.

Reintroducing Foods

If all your symptoms are completely gone after a week, you may begin the challenge phase. If not, I typically encourage people to wait 14 days. By this time, food related symptoms are usually gone or have noticeably decreased, yet you are still within the window of time in which your reactions will be relatively easy to identify. To challenge foods, reintroduce the foods you eliminated one at a time. Pick one and ingest it two times in the same day (unless you have an obvious reaction after the first ingestion). Don’t change anything else in your diet for the next 48 hours because sometimes reactions can take up to 2 days to appear. During this time, evaluate your symptoms. Record the food eaten along with the date in the left hand column of your symptoms list and rate each of your symptoms. If you have no reaction to the food after 2 days, you may then incorporate it into your diet and challenge the next food. If you do have a reaction, remove the food from your diet again and wait until your reaction has calmed down before challenging the next food. This process will help you uncover allergies, sensitivities, and reactions to foods.

Some examples of success

This is not an easy process. However, if you do discover a significant food reaction, eliminating it from your diet can make a huge impact on your life and your health. I had a 9 year old patient who was having a range of emotional and behavioral issues: difficulty concentrating in school, being disruptive in class, fighting with other children, and being unable to sit still at home. During the course of an elimination and challenge, we identified a reaction to corn. His parents removed corn and corn products from his diet, and his behavior transformed. He became attentive and well-behaved in class, stopped getting in fights and began playing well with other kids, and his mother said for the first time since she could remember, he participated with the family in the evenings watching television or talking.
I had another patient who came to me complaining of excruciating abdominal pain that sent him to the ER an average of twice a month. He had had extensive imaging done and had been given prescriptions for pain, all to no avail. I ran labs on him and discovered a marker for gluten sensitivity. Using an elimination and challenge diet, we discovered that gluten was a major issue. He eliminated gluten from his diet, and his abdominal distress disappeared completely.

Final Words of Encouragement

Knowledge is power. The more you know about the things that impact and affect your health, the more choices you have in how to deal with them. I have outlined the basic process for an elimination and challenge diet for you, but there are many resources to help you through the confusing details. Websites such as celiac.org, cornallergens.com, and godairyfree.org are just a few places that offer recipes as well as assistance in locating hidden derivatives of foods in the diet. Adrenalfatigue.org has a section that discusses the connection between adrenal function (i.e. stress) and allergies (Adrenal Function in Health Conditions – Allergies) and also lists many of the foods that contain the common allergens (Adrenal Function in Health Conditions – Allergens). Challenge yourself to try an elimination and challenge diet; you may discover that the foods you were eating regularly were adding to your stress and that without them you feel better than you ever thought you could.

About the Author

Dr. Lise NaugleDr. Lise Naugle is an associate of Dr. James L. Wilson. She assists healthcare professionals with clinical assessment and treatment protocols related to adrenal dysfunction and stress, and questions regarding the use of Doctor Wilson’s Original Formulations supplements. With eleven years in private practice and a focus on stress, adrenals, hormonal balance and mind-body connection, she offers both clinical astuteness and a wealth of practical knowledge. Dr. Naugle also maintains updated information about the latest scientific research on the hypothalamic-pituitary-adrenal axis function, endocrine balance and nutritional support for stress and develops educational materials about stress and health for clinicians and their patients.

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Identifying Food Allergies, Sensitivities, and Intolerances

In part 1 of this blog, “Making Sense of Food Allergies, Sensitivities, and Intolerances,” I explained the various ways you may be sensitive, allergic or intolerant to specific foods and how these can impact your health and put additional stress on your adrenals. In Part 2 below, I will help you understand some ways to identify them, and in my next blog, Part 3, I’ll show you how to eliminate them.

IgE Food Allergies – The Usual Suspects

suspectsIn order to overcome any type of food reaction, you must first identify which foods are causing problems. Eight foods are responsible for approximately 90% of food allergies: shellfish, milk, egg, wheat, peanut, tree nuts, fish, and soy. In the case of the “typical” food allergy it is usually easy to identify a problem if you ingest the food. One bite can cause an immediate allergic reaction.  These allergic reactions are known as IgE mediated allergies or immediate hypersensitivity reactions. IgE refers to the type of antibody produced by the immune system in response to the allergen. Antibodies are the immune cells your body makes against something your body identifies as “foreign.” Because this type of reaction can be severe, it is preferable to determine IgE allergies without actually eating the food in question.  IgE allergies can usually be discovered via a skin prick test by an allergist. A tiny amount of the food is applied to pricked skin. A positive test causes a red wheal (hive). This test is very sensitive, but not very specific. That means that sometimes someone will react to the test for a food when they actually are sensitive to a related food. For this reason, it’s important to use this test along with a thorough diet history and only test relevant foods. Also, there is a small chance that someone could have a severe allergic reaction to the test foods. A possible alternative is to test for IgE allergies via a blood test, called a RAST test, and avoid the possibility of a dangerous allergic response. Just know that these are fairly expensive, aren’t as sensitive, are not available for all foods, and typically need to be confirmed by eating the foods in question and looking for a response. (Because IgE mediated responses can be dangerous, it is best to do this under the care of a physician.)

In the case of food sensitivities in which an immune reaction results from antibodies other than IgE, there are different lab tests that can be done. Typically these test IgG or IgA antibodies. IgG is the main antibody in the blood while IgA is the primary antibody in the digestive and respiratory tracts. Typically IgA and IgG food allergy tests involve adding a drop of your blood to food antigens (the protein portion of the food to which the immune system reacts) and looking for a reaction. The IgG test is more sensitive (it can detect the correct antibodies more easily) but less specific (it sometimes detects the wrong antibodies). The IgA test is more specific and less sensitive. If you decide to do these tests, it is very important that you have been eating the foods you’re testing for roughly 6 weeks or longer before you have your blood drawn. Your body does not make antibodies against an antigen (the food in this case) unless it is exposed to it. So even if you are reactive to a food, after you haven’t eaten it in a while your antibody levels will go down – wonderful news when treating the condition, but problematic when testing. Unfortunately, these tests are also relatively expensive, not always reproducible, and the results on paper don’t always correlate with the symptoms you experience.

Celiac Disease

celiac's diseaseIn celiac disease, an autoimmune disorder, a very specific type of immune reaction occurs. The body creates antibodies against certain proteins found in wheat and other grains, and these antibodies then attack the body’s own intestinal cells mistaking them for foreign cells (auto=self: autoimmune = immunity against self).  Historically, a biopsy of the digestive tract has been considered the gold standard for diagnosing celiac. Now there are lab tests which some physicians feel can predict celiac as accurately as a biopsy if used in conjunction with a food challenge. The most commonly ordered tests are for anti-gliadin antibodies (antibodies against a specific portion of the gluten protein) and tissue transglutaminase antibodies (antibodies that attack the intestinal cells).

These same tests can sometimes be useful in looking for gluten sensitivity unrelated to abdominal or intestinal problems, but there are limitations. One of the primary problems is that there are many proteins on the grain in addition to those that we know cause celiac disease, and lab tests aren’t available for most of them. If you are reacting to a protein in the grain other than the few we have a test for, nothing will show up on the lab test.

Testing for Food Intolerances

For food intolerances there are sometimes tests available. For example, in the case of lactose intolerance, there are two common tests. Each begins with drinking a liquid with high levels of lactose. In one, blood sugar levels are measured after a couple hours. If your blood sugar doesn’t rise, you aren’t breaking down and absorbing the milk sugar. In the other test, the amount of hydrogen you exhale is measured at regular intervals for up to 3 hours after drinking the liquid. Typically, people don’t exhale a large amount of hydrogen, but if you are not absorbing the lactose, the milk sugar gets broken down by colonic bacteria that create a lot of hydrogen and other gases (one of the main reasons lactose intolerance is so painful!). Lab tests don’t exist for every food intolerance though, or for most of the sensitivities related to the drug-like components in food. In the case of caffeine, sometimes an elevated heart rate or blood pressure will let you know that you are sensitive to the stimulant effects, but for many pharmacological components, there is nothing easily measurable.

If you’ve been reading closely, you may have noticed some patterns emerging:  although many lab tests exist and can prove useful, none is 100% accurate, most are fairly expensive, and there are many situations for which we don’t even have lab tests. This is why in my practice I encouraged my patients to do an elimination and challenge diet rather than a laboratory test (except in the case of IgE mediated allergies). The diet is much less expensive than the labs; will help detect various types of food reactions- allergies, sensitivities, intolerances, and reactions to pharmacologically active food constituents- and it is the first step in treatment as well. Stay tuned for the next blog in which I describe how to do the elimination and challenge diet.

Continue to part 3 – Eliminating Food Allergies, Sensitivities, and Intolerances

About the Author

Dr. Lise NaugleDr. Lise Naugle is an associate of Dr. James L. Wilson. She assists healthcare professionals with clinical assessment and treatment protocols related to adrenal dysfunction and stress, and questions regarding the use of Doctor Wilson’s Original Formulations supplements. With eleven years in private practice and a focus on stress, adrenals, hormonal balance and mind-body connection, she offers both clinical astuteness and a wealth of practical knowledge. Dr. Naugle also maintains updated information about the latest scientific research on the hypothalamic-pituitary-adrenal axis function, endocrine balance and nutritional support for stress and develops educational materials about stress and health for clinicians and their patients.

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